Data Exchange For Quality Measures Implementation Guide
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Data Exchange For Quality Measures Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 5.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-deqm/ and changes regularly. See the Directory of published versions

Extension: DEQM Group Improvement Notation Extension

Official URL: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-groupImprovementNotation Version: 5.0.0
Standards status: Trial-use Active as of 2025-12-19 Maturity Level: 4 Computable Name: DEQMGroupImprovementNotationExtension
Other Identifiers: OID:2.16.840.1.113883.4.642.40.2.42.11

Indicates whether improvement in the measure group is noted by an increase or decrease in the measure score.

Context of Use

Mandatory Data Elements and Terminology

The following data-elements are mandatory (i.e data MUST be present).

Each Extension Must Have:

  1. url: identifies the meaning of the extension

Introduction

This extension allows improvement notation to be specified at the group level rather than the measure level. However, it should be noted that if you specify improvement notation at the measure level it cannot be specified at the group level and if you specify it at the group level you must specify it for all groups and not at the measure level.

Usage info

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Extension Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension Extension
... extension 0..0 Extension
... url 1..1 uri "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-groupImprovementNotation"
... value[x] 0..1 CodeableConcept Value of extension
Slice: Unordered, Open by type:$this
... valueCodeableConcept 0..1 CodeableConcept Value of extension
Binding: MeasureImprovementNotation (extensible)

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Extension.valueCodeableConcept Base extensible MeasureImprovementNotation 📦4.0.1 FHIR Std.
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension Extension
... id 0..1 string Unique id for inter-element referencing
... extension 0..0 Extension
Slice: Unordered, Open by value:url
... url 1..1 uri "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-groupImprovementNotation"
... Slices for value[x] 0..1 CodeableConcept Value of extension
Slice: Unordered, Closed by type:$this
.... value[x]:valueCodeableConcept 0..1 CodeableConcept Value of extension
Binding: MeasureImprovementNotation (extensible)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Extension.value[x]:valueCodeableConcept Base extensible MeasureImprovementNotation 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Summary

Simple Extension with the type CodeableConcept: Indicates whether improvement in the measure group is noted by an increase or decrease in the measure score.

Maturity: 4

Differential ViewDifferential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension Extension
... extension 0..0 Extension
... url 1..1 uri "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-groupImprovementNotation"
... value[x] 0..1 CodeableConcept Value of extension
Slice: Unordered, Open by type:$this
... valueCodeableConcept 0..1 CodeableConcept Value of extension
Binding: MeasureImprovementNotation (extensible)

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Extension.valueCodeableConcept Base extensible MeasureImprovementNotation 📦4.0.1 FHIR Std.

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension Extension
... id 0..1 string Unique id for inter-element referencing
... extension 0..0 Extension
Slice: Unordered, Open by value:url
... url 1..1 uri "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-groupImprovementNotation"
... Slices for value[x] 0..1 CodeableConcept Value of extension
Slice: Unordered, Closed by type:$this
.... value[x]:valueCodeableConcept 0..1 CodeableConcept Value of extension
Binding: MeasureImprovementNotation (extensible)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Extension.value[x]:valueCodeableConcept Base extensible MeasureImprovementNotation 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Summary

Simple Extension with the type CodeableConcept: Indicates whether improvement in the measure group is noted by an increase or decrease in the measure score.

Maturity: 4

 

Other representations of profile: CSV, Excel, Schematron